http://localhost:8080/xmlui/handle/123456789/11383 2026-04-11T21:08:25Z http://localhost:8080/xmlui/handle/123456789/11648 Title: The dynamics of intercultural clinical encounters in times of pandemic crisis. Swedish healthcare providers’ reflections on social norms in relation to sexual and reproductive healthcare Authors: Appelback, Mia; Carlbom, Aje; Eriksson, Lise; Ess´en, Birgitta Abstract: Background: Experiences from the COVID-19 pandemic may help to better understand resilience, competences and skills for healthcare providers and the healthcare system. Within sexual and reproductive health inequalities for migrants exist and it is an area where promoting both cultural competency and healthcare equity in the clinical encounter is expected of healthcare providers yet can create tension. The aim is to explore healthcare providers experiences of encounters with migrants in the context of the pandemic and the subsequent changes in routines and norms. Methods: A qualitative study based on semi-structured interviews with 31 healthcare providers working in sexual and reproductive healthcare in southern Sweden. Interviews were conducted during the COVID-19 pandemic influencing how healthcare providers reflected on their experiences. Analysis was done using reflexive thematic data analysis. Findings: Healthcare providers reflected on how changes in routines increased the understanding of challenges and enablers in the intercultural encounter including the impact on communication and role of relatives and male partners. They emphasized the dynamics of culture in the clinical encounter and healthcare system through highlighting the importance of structural awareness, self-reflection and the flexibility of conducts and norms, often given a cultural connotation. Conclusion: The COVID-19 pandemic resulted in changes of previously established routines directly affecting clinical encounters, which provided a unique opportunity for healthcare providers to reflect, with communication and self-reflection being discussed as central in complex encounters. It highlighted the dynamics of presumed deeply rooted cultural norms and the interplay with social factors affecting healthcare providers and patients alike. 2024-07-01T00:00:00Z http://localhost:8080/xmlui/handle/123456789/11647 Title: Shared decision-making in maternity care in Saudi Arabia: A cross-sectional study Authors: Alruwaili, Tahani Ali; Crawford, Kimberley; Fooladi, Ensieh Abstract: Background: Shared decision-making (SDM) in maternity care involves women actively in decisions, thereby reducing decisional conflicts and enhancing satisfaction with care. Aim: To investigate SDM and the factors associated with it, and its correlation with respect in maternity care in Saudi Arabia. Methods: A comprehensive, nationwide online questionnaire-based study was conducted between January to May 2023, involving women aged 18 years and above who were either pregnant or had experienced pregnancy/ childbirth in the past 12 months. The Mothers’ Autonomy in Decision-Making (MADM) scale and the Mothers of Respect Index (MORi) were used. Low to very low SDM was defined as a score of ≤ 24 on the MADM and low to very low respected was defined as a score of ≤ 49 on the MORi. Results: A total of 505 women completed the survey. Low to very low SDM was reported by 137 (34.1 %, 95 confidence interval (CI), 29.6 % - 38.9 %) women. Factors significantly associated with low to very low SDM included seeing different obstetricians of different gender at each visit (adjusted odds ratio (AOR) 2.0, 95 % CI, 1.0 – 3.9), not meeting the same obstetrician throughout the pregnancy (AOR 2.6, 95 % CI, 1.2 – 5.6) and having an instrumental vaginal birth (AOR 6.67, 95 % CI, 1.6 - 28.1). There was a positive association between low to very SDM and feeling of low to very low respect ((χ2 = 83.8173, p < 0.001). Conclusion: More than one-third of women experienced low to very low SDM in maternity care. This should alert healthcare providers to the importance of continuity of care in Saudi Arabia. 2024-08-01T00:00:00Z http://localhost:8080/xmlui/handle/123456789/11645 Title: Registered nurse lactation consultants’ experiences supporting maternal mental health: A qualitative descriptive study Authors: DeCoste, Kelly L.; Benoit, Britney L.; Dewart, Georgia K.; Johnson, Steven T. Abstract: Background: The province of Nova Scotia has the highest rates of perinatal mental health disorders in Canada, and rates of exclusive breastfeeding fall below the Canadian national average. Exclusive breastfeeding is identified as a protective factor against the development of perinatal mental health disorders. Lactation consultant support is associated with increased rates of exclusive breastfeeding and decreased rates of perinatal mental health disorders. Despite this, little is known regarding the experiences of Registered Nurse Lactation Consultants related to supporting maternal mental health. Objective: To understand the experiences of Registered Nurse Lactation Consultants related to supporting maternal mental health. Design: A qualitative descriptive design using online semi-structured interviews. Setting & Participants: Ten Registered Nurse Lactation Consultants employed in the publicly funded healthcare system in Nova Scotia, Canada, were recruited via purposive sampling. Findings: Three themes emerged regarding the relational experiences of Registered Nurse Lactation Consultants while supporting maternal mental health; these included (1) Experiences supporting maternal mental health, (2) Providing maternal mental health care, and (3) Mothers need support. Key conclusions and implications for practice: Registered Nurse Lactation Consultants described positive experiences supporting maternal mental health and indicated that lactation consultant appointments were an opportune time to provide screening and support for maternal mental health. Enhancing support for maternal mental health requires collaborative and integrated approaches throughout the perinatal period. Healthcare providers, including Registered Nurse Lactation Consultants, must be provided with the support and resources to provide timely and appropriate support for maternal mental health throughout the perinatal period 2024-08-01T00:00:00Z http://localhost:8080/xmlui/handle/123456789/11644 Title: Novel solutions to the midwifery retention crisis in England: an organisational case study of midwives’ intentions to leave the profession and the role of retention midwives Authors: Feeley, Claire; Stacey, Tomasina Abstract: Problem/Background: : Midwifery retention is a global issue, but less is known regarding what motivates midwives’ intention to stay or leave within individual organisations. In 2021, NHS England funded maternity organisations to employ retention midwives. To date, the impact of these roles has not been evaluated. Aim: : To explore the views of midwives regarding their intentions to leave or stay within one English organisation and to provide insights into the perceived impact of the role of retention midwives. Methods: : An instrumental case study was carried out in one organisation. Data a mixed methods survey (n=67/ 91) and interview data (n=7). Quantitative data was analysed using descriptive and inferential statistics; qualitative data using thematic analysis. All data was synthesised together. Findings: : The three themes included ‘Values-based tensions: The eroding role of the midwife’; ‘Discerning differences: Intentions to leave or stay’; ‘Retention midwives: Activities and impact’. Discussion: : We found that there was a clear link between midwives’ intention to leave or stay and their workplace roles; specialist midwives were more likely to stay, report satisfaction, autonomy, and feel a sense of contribution or effectiveness in their role compared to those in other roles. The retention midwives were making a positive difference to midwives’ experience of the workplace. Conclusion: : Midwives working within the same organisation have different experiences of their role and job satisfaction. Future work should consider applying the positive elements of the specialist roles to the wider midwifery workforce to enhance retention. The retention midwife role shows promise, but further evaluation is required. 2024-08-01T00:00:00Z